ENDOSCOPIC VERSUS OPEN SUBFASCIAL DIVISION OF INCOMPETENT PERFORATING VEINS IN THE TREATMENT OF CHRONIC VENOUS INSUFFICIENCY | ||
| The Egyptian Journal of Surgery | ||
| Volume 20, Issue 3, July 2001, Pages 657-663 PDF (427.65 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2001.376357 | ||
| Author | ||
| Hany Aly Nowara* | ||
| Assistant professor of surgery, Cairo University, Egypt | ||
| Abstract | ||
| Purpose: Subfascial division of incompetent perforating veins plays an important role in the surgical treatment of patients with chronic venous insufficiency of the lower leg. To minimize the high incidence of postoperative wound complications after open exploration, endoscopic approaches have recently been developed. This study compares between open and endoscopic treatment of these patients concerning ulcer healing and postoperative wound complications. Methods: Patients with current venous ulceration on the medial side of the lower leg were allocated to open exploration by the modified Linton approach (Group I) or endoscopic exploration by use of a laparoscope (GroupII). Results: Fifty patients were allocated for this study. The incidence of wound infections after open exploration was 53%, compared with 0% in the endoscopic group (P< 0.001). Patients in the open group needed longer hospital stays (mean=8 days; range= 3 to 42 days) than patients in the endoscopic group (mean= 3 days; range= 1 to 6 days; P= 0.001). After the operation the ulcers of 84% of patients in the open group and 88% in the endoscopic group had healed. The patients were followed (6 to 24 months), recurrences had occurred in two patients in group I & one patient in group II. Conclusions: Endoscopic division of incompetent perforating veins is equally as effective as open surgical exploration for the treatment of venous ulceration of the lower leg but leads to significantly fewer wound healing complications. Endoscopic division of the perforators is there fore the preferred method. | ||
| Keywords | ||
| Endoscopy; perforators; venous insufficiency; venous ulcer | ||
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